Academic Review 2024

29 ACADEMIC REVIEW 2024

Historic events in American history like the case of Henrietta Lacks (Moorhead, 2010) and the testing of enslaved black women (Bachynski, 2018) will be evaluated. More light will be shed on the nutritional experimentation which indigenous students faced in Canadian residential schools (Mosby & Galloway, 2017) as well as the health problems which still affect the community. From clinical trials excluding women to transgender women being overlooked, the misdiagnosis, mistreatment, and exclusion of women in healthcare will be discussed. Though healthcare providers can also be targeted unjustly by patients (Tello, 2017), the focus of this essay is the discrimination faced by patients from healthcare providers and the system. Both healthcare providers and patients should be treated with respect and discrimination towards either is wrong.

Health disparities are experienced by various groups of people and there are many reasons for this difference which include social, economic or environmental disadvantage. Discrimination is treating a certain group of people differently in a negative/positive way because of a specific characteristic that they have (Cambridge Dictionary, 2019). In this essay I will specifically be looking at health disparities which women and people of colour face. Individuals from all socioeconomic backgrounds in these two groups face discrimination. An example of this is antenatal care. Black women in the UK are five times more likely to die in pregnancy, childbirth or in the postpartum period in comparison to their white counterparts (Knight, et al., 2019). Women of colour from all socioeconomic backgrounds are affected by bias as it impacts the quality of healthcare which they receive. High-profile black women like Serena Williams and Beyoncé Knowles have voiced how they struggled during their childbirth as a result of their race (Kasprzak, 2019). I will explore both explicit bias and implicit bias in healthcare. Implicit bias and decision making Decision-making is influenced by implicit bias on a subconscious level without our knowledge (Sabin, Rivara, & Greenwald, 2008). Diagnoses for diseases typically come from the use of cognitive shortcuts or heuristics like the stereotyping of diseases and recognising patterns. Time is reduced when cognitive shortcuts are used allowing doctors to give a diagnosis to a patient more quickly. However, they are sometimes less accurate and increase the number of biases. In some instances shortcuts are helpful as they come from a physician’s knowledge of medicine. In healthcare, decisions are made under a great deal of pressure and stress. Therefore biases are more likely to occur due to the high cognitive demand (Sabin, Rivara, & Greenwald, 2008). Cognitive shortcuts can become a problem because of implicit attitudes and stereotypes that the healthcare provider holds. The quality of care a patient receives is determined by both implicit attitudes and medical information. Patient safety may be compromised as the implicit attitudes that the healthcare provider holds may affect the treatment plan they are put on. For example, a common stereotype is that women have excessive emotion and are “hysteric” (Cleghorn, 2021). This means

that their treatment plan may have less analgesics, a type of medication which relieves pain, (de Falla, 2022) because of this false stereotype. The patient might not be on the correct treatment which could possibly lead to a prolonged period of bad health for them. Implicit bias can be to blame for this. The elimination of biases is hard as we look for information that confirms the views that we hold. This concept was suggested by Peter Wason who was a cognitive psychologist in the 1960s (Evans, 2003). The different biases in confirmation bias include myside bias which is trusting your gut and default bias which is conforming to social norms. We commonly stick with what we know because it activates the ventral striatum (Agarwal, 2020) which makes sure that we feel rewarded when we stick to what we know. The parts of the brain which are involved with reward processing and behavioural adjustments alter depending on whether we keep our perspective the same as that of the group (society) or if we change it. When our perspective is different to that of the group, neuroimaging has shown there to be higher activity in the rostral cingulate zone (a zone in the medial prefrontal